EXPANDED PROGRAM ON IMMUNIZATION

Topics: Vaccine, Vaccination, Polio vaccine Pages: 6 (1427 words) Published: December 5, 2013
Expanded Program on Immunization
I. Rationale
The Expanded Program on Immunization (EPI) was established in 1976 to ensure that infants/children and mothers have access to routinely recommended infant/childhood vaccines. Six vaccine-preventable diseases were initially included in the EPI: tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles. In 1986, 21.3% “fully immunized” children less than fourteen months of age based on the EPI Comprehensive Program review.

II. Scenario
Global Situation
The burden
In 2002, WHO estimated that 1.4 million of deaths among children under 5 years due to diseases that could have been prevented by routine vaccination. This represents 14% of global total mortality in children under 5 years of age.

Source: Weekly Epidemiological Record, WHO: No.46,2011,86.509-520)
Burden of Diseases
The immunization coverage of all individual vaccines has improved as shown in Figure 1: (Demographic Health Survey 2003 and 2008). Fully Immunized Child (FIC) coverage improved by 10% and the Child Protected at Birth (CPAB) against Tetanus improved by 13% compared to any prior period. Thus, the Philippines has now historically the highest coverage for these two major indicators.

Figure 1: Comparison of the 2003 and 2008 EPI indicators, Source: NDHS

III. Interventions/ Strategies
Program Objectives/Goals:

Over-all Goal:
To reduce the morbidity and mortality among children against the most common vaccine-preventable diseases.
Specific Goals:
1. To immunize all infants/children against the most common vaccine-preventable diseases. 2. To sustain the polio-free status of the Philippines.
3. To eliminate measles infection.
4. To eliminate maternal and neonatal tetanus
5. To control diphtheria, pertussis, hepatitis b and German measles. 6. To prevent extra pulmonary tuberculosis among children.
Mandates:
Republic Act No. 10152“MandatoryInfants and Children Health Immunization Act of 2011Signed by President Benigno Aquino III in July 26, 2010. The mandatory includes basic immunization for children under 5 including other types that will be determined by the Secretary of Health.

Strategies:
Conduct of Routine Immunization for Infants/Children/Women through the Reaching Every Barangay (REB) strategy REB strategy, an adaptation of the WHO-UNICEF Reaching Every District (RED), was introduced in 2004 aimed to improve the access to routine immunization and reduce drop-outs. There are 5 components of the strategy, namely: data analysis for action, re-establish outreach services, , strengthen links between the community and service, supportive supervision and maximizing resources. •Supplemental Immunization Activity (SIA)

Supplementary immunization activities are used to reach children who have not been vaccinated or have not developed sufficient immunity after previous vaccinations. It can be conducted either national or sub-national –in selected areas.

Strengthening Vaccine-Preventable Diseases Surveillance
This is critical for the eradication/elimination efforts, especially in identifying true cases of measles and indigenous wild polio virus •Procurement of adequate and potent vaccines and needles and syringes to all health facilities nationwide

IV. Status of implementation/ Accomplishment
All health facilities (health centers and barangay health stations) have at least one (1) health staff trained on REB.
Polio Eradication:
The Philippines has sustained its polio-free status since October 2000. •Declining Oral Polio Vaccine (OPV) third dose coverage since 2008 from 91% to 83%. A least 95% OPV3 coverage need to be achieved to produce the required herd immunity for protection.

Figure 2 OPV1 and OPV3 Coverage, Philippines, 2005-2010

There is an on-going polio mass immunization to all children ages 6 weeks up to 59 months old in the 10 highest risk areas for neonatal tetanus....
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